What seeing a therapist is really like

Taking the plunge to start counselling can be transformative, but it helps to get the lowdown before you start.

By
Kim Easton-Smith

Jul 25, 2018

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It can be nerve-wracking and overwhelming, making the decision to see someone about your mental health. So if you’re thinking about it, you’ve already made a big step.

The next is to choose what kind of therapist and therapy is right for you, and make the commitment to show up every time - both physically and emotionally.

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It’s natural to be nervous about something new, especially when it involves exploring feelings you may not have considered ever before, so we spoke to Counselling Directory member, therapist Maureen Brumby, to find out what to expect when you start therapy.

Every therapist is different

“Therapists are not all the same,” explains Maureen. “Don’t assume ‘any will do’.

“Choosing a therapist is a very personal decision and it pays to do your homework. Read professional profiles on somewhere like Counselling Directory, which is affiliated with the BACP professional body, and look at their areas of expertise. If any chime with what you’re concerned about, get in touch and ask for more information or set up an initial phone appointment.

“Remember, no good work can occur unless the therapeutic relationship is a comfortable match. Your therapist should make you feel safe and comfortable and that you can trust him or her. Don’t be afraid to try someone new if you don’t feel this way.”

Therapy is not one-size-fits-all

The NHS lists nine types of talking therapy commonly used in the UK:

Counselling

Cognitive Behavioural Therapy (CBT)

Psychotherapy

Family counselling

Relationship counselling

Group therapy

Interpersonal therapy

Behavioural activation

Mindfulness-based therapy

The most common are the first two, but CBT and mindfulness have both gained popularity in recent years. Many therapist combine therapies for individual clients.

Maureen says: “First, speak to your potential therapist over email or on the phone and outline what the issues are. The therapist should be able to give advice and information on the base of this, and if they are competent (and assuming ethical!), they will be able to say whether they think they will be a good fit.

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“Therapists can be educated and qualified in a whole range of different approaches, so ideally they will be able to use their knowledge to create an integrated treatment based on your individual personality and concerns.

“Don’t be afraid to ask your therapist to explain the types of therapy to you and how he or she’s using them in your case. And remember, you can always change your therapist.”

What to expect from your first session

The movies might make you think of lying on a couch, pouring your heart out to a faceless man sitting behind you furiously taking notes, but in reality, therapy is much more interactive and comfortable.

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Therapists are just normal people too, so they should introduce themselves, ask you questions about why you’re there and how they can help and make you feel comfortable. You’ll probably sit on chairs, facing each other, and it can feel quite informal.

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“When someone makes that first courageous step forward to get in contact with a therapist the work already begins,” says Maureen. “You might not know exactly what’s wrong or where to start, but you’ve recognised that you feel troubled, lost, in pain, etc. A good therapist will be able to work with the client to help them to identify what the problem is.

“This work is done very gently and sensitively and of course empathically. It’s ok to be quiet, it’s ok to not talk. My job is to help my clients to be able to help themselves.

“You may genuinely not know what is wrong, but something is wrong otherwise you wouldn’t have contacted me and be sitting in my therapy room with me.

“I observe non-verbal cues too, such as body language, and by the end of the session we usually have a good idea of what’s wrong.”

Counselling isn’t a passive activity. It hinges on your willingness and commitment to do the work. It also depends on the issues you’re dealing with.

“You can’t predict how long it will take,” says Maureen. “CBT can be quick to make changes in some cases, as it’s more prescriptive. Early childhood issues, that need psychotherapy, can take longer to work through. ‘Feeling better’ is totally subjective, and can change week to week, and there can be relapses. That’s normal.”

Something to be aware of is the possibility that you might feel worse before you feel better - but that doesn’t mean it’s not working.

“Quite often this is a factor,” advises Maureen. “In therapy when we begin deeper work that takes the client to emotions that were suppressed, hidden, avoided or perhaps even unknown, it’s important to feel these feelings and understand the phenomena.”

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Therapy isn't a magic bullet

Talking therapies are very effective, and have helped millions of people, but sometimes it’s not the right thing for you, or it’s not the right time. This doesn’t mean you, or the therapy, have failed, and it shouldn’t put you off trying it again in the future.

Maureen explains: “Unfortunately, therapy does not always work due to various factors, such as personal attitude, the circumstances of referral, and being able to understand the process and stay committed even when it’s difficult.

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“It’s unfortunate when it doesn’t work for some, though I have not had this experience often.”

Most people find therapy tough, rewarding and enlightening so it’s always worth dedicating yourself to it and seeing where it can take you.

Maureen Brumby is a qualified counsellor and Registered Member of the British Association for Counselling and Psychotherapy (BACP), offering a range of counselling and therapy options.

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